-LRB- CNN -RRB- -- The U.S. Supreme Court made a landmark ruling Thursday upholding the controversial , massive reform of health care coverage initiated by President Barack Obama .

Here are four things Americans learned about the federal government 's grand vision to ensure health care for everyone under so-called Obamacare :

Skipping insurance no longer an option

The individual mandate is the centerpiece of the Affordable Care Act , the Obama administration 's signature law . The mandate , which the high court let stand , requires most Americans to have health care insurance .

Opponents had contended that the government could n't force citizens to buy health coverage , but the Supreme Court ruled Thursday that the individual mandate is legal under the government 's taxing powers . The `` tax '' comes in the form of a financial penalty on certain individuals who do not obtain health insurance , and the Constitution allows for such a tax , the court said .

The justices , however , found problems in how the law threatens to remove Medicaid funding -- the government 's health coverage for the poor -- from states that do n't participate in an expansion of eligibility . The court said that the government must remove that threat , and Obama acknowledged remedies are needed .

The year 2014 is the deadline for everyone to get insurance .

Not obtaining insurance in 2014 will cost a person $ 95 or 1 % of his or her income , whichever is higher . In 2015 , it 's $ 325 , or 2 % of income . For families , the penalty will be $ 285 per household or 1 % of income , whichever is greater . By 2016 , it goes up to $ 2,085 per family or 2.5 % of income . Penalties will rise each year .

Health care ruling gives GOP new attack line -- taxes

The law promises improved collective health

The law does promise better care and better health for America -- at a cost . Federal health spending is projected to grow from 5.6 % of gross domestic product in 2011 to about 9.4 % by 2035 , according to the Kaiser Family Foundation .

Under the law , preventive care services such as mammograms , physical exams , colonoscopies and vaccinations will be fully covered by insurance companies . This requirement kicked in for new health insurance plans that began on or after September 2010 .

Without the individual mandate , 40 million Americans would have remained uninsured , researchers at the Urban Institute 's Health Policy Center estimated .

Had the health care law been struck down by the high court , those without insurance would have grown by millions , researchers at the Urban Institute said .

Without the law , `` in the worst case scenario , the number of uninsured Americans would increase to 57.7 million in 2014 and to 65.7 million in 2019 . In the best case , the number grows to 53.1 million in 2014 and 57 million in 2019 , '' the researchers wrote .

` Obamacare ' symbol : Court ruling is ` right direction '

Uninsured not the only ones who 'll see a change

Many Americans are already covered by employers ' health benefits .

At companies with fewer than 50 workers , the employees must obtain insurance themselves .

Companies with 50 or more full-time employees must start providing health insurance for all workers by 2014 or face stiff penalties .

Cash-strapped entrepreneurs can buy insurance at state exchanges and can get tax credits if their annual individual income ranges between 100 % and 400 % of the poverty line , which this year translates to $ 11,170 and $ 44,680 .

Solo entrepreneurs and small businesses can shop for less expensive insurance through the exchanges in each state .

One-person businesses can also turn to exchanges for individuals . Companies with up to 100 workers may turn to Small Business Health Options Programs . Both keep down costs by increasing the size of the insured pool and spreading out the risk .

No exchange is up and running yet . In theory , though , the exchanges will give small firms the ability to buy insurance at rates once belonging to large companies .

By the numbers : Health insurance

Both parties will look to benefit politically from ruling

On Thursday , Republicans indicated that the health care law will be a major issue in this year 's presidential election . Obama , a Democrat , agreed .

Republican presidential candidate Mitt Romney said that , if elected , he would seek to overturn the law .

Both candidates were leveraging the conflict to raise money for their respective campaigns .

`` What the court did not do on the last day in session , I will do on my first day if elected president of the United States , and that is that I will act to repeal Obamacare , '' Romney said two hours after the ruling was handed down .

Despite his pledge to repeal the law , if elected , Romney has promised to continue some of the law 's consumer protections , such as the ban on preventing care based on pre-existing conditions .

Said Obama : `` I know that there will be a lot discussion about this , about who won and who lost . That 's how these things tend to be viewed here in Washington . But that discussion completely misses the point . ''

He said Thursday that the principle upheld by the high court 's ruling is that no American should go bankrupt because of illness .

Opinion : Are voters ready to move on ?

What the health care ruling means to you

CNN 's Tom Cohen , Rich Barbieri , Jennifer Bixler and Jeanne Sahadi contributed to this report .

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The controversial individual mandate is deemed constitutional as a tax matter

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Americans must have health care coverage -- or face fines

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The ruling will continue to play a role this year 's presidential election

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The law will allow more people access to preventive screening